For much of its history, chronic obstructive pulmonary disease was considered a “man’s disease,” both because men traditionally smoked more and because they had higher exposure to occupational lung irritants like mining dust and certain chemicals. But the steady rise in cases of COPD diagnosed in women over the past 30 years indicates that women have probably caught up and may now exceed men in developing the disease and dying of it.
A 2014 report from The American Lung Association, ” Taking her Breath Away: The Rise of COPD in Women,” states that more than 7 million women in the United States live with COPD, and millions more may be living with the disease without a diagnosis. In women, COPD is often misdiagnosed as asthma, and deaths from COPD have quadrupled since the 1980s. “In 1979, the number of men dying from COPD was almost three times that of women. By the year 2000, COPD had claimed the lives of more women than men for the first time, and women now account for roughly 53 percent of all deaths attributed to COPD in this country,” the report states.
[See: 8 Surprising Facts About Asthma and Seasonal Allergies.]
Why COPD is now affecting women more than men is complicated, but largely related to cigarette marketing. Remember those Virginia Slims cigarette advertisements from the late-1960s onward that were clearly targeted at young, professional women? When they said “you’ve come a long way, baby,” smokers likely didn’t realize that way could eventually lead to a COPD diagnosis. But Dr. Umur Hatipoglu, director of the COPD Center at the Respiratory Institute at Cleveland Clinic, says the rise in women smoking in the latter half of the 20th century is clearly related to the increased rate of COPD in women today.
“The reason epidemiologically why women have a higher rate [of COPD] now is explained by the observation that peak incidence of women who smoked occurred in the 1980s, a decade later than men. So, we’re seeing the anticipated rise in the COPD incidence in women,” he says.
Hatipoglu also says the higher rates of COPD in women may be “dose related.” Taking the average size differential between men and women into account, if a man and a woman both smoked the same cigarette, “the same amount of smoke is distributed to a larger area in the [man’s] lung because men’s airways and lungs are larger than an average woman’s.” This means that the average female smoker’s lungs are exposed to more concentrated doses of inhaled toxins from cigarettes than men, which can lead to more damage to the tissue and ultimately COPD.
But there is likely more to the increase in women diagnosed with COPD than just smoking. Hatipoglu says that although it’s a “relatively new area of research,” differences have been detected in pulmonary emphysema in women compared to men. “Airway diameters are smaller” in women typically, and “the airway walls are thicker in women,” meaning that emphysema in women tends to occur more in the center of the lung and not as much at the outer edges, or “the periphery of the lung. So there are morphological differences in men and women in how the disease manifests as well.”
[See: 7 Lifestyle Tips to Manage Your Asthma.]
What’s more, women are more than twice as likely as men to develop chronic bronchitis. According to a 2007 review study conducted at the University of Michigan, hormonal differences and their fluctuations throughout a woman’s lifetime may play a role in the development of asthma, chronic bronchitis and COPD, and “the increased responsiveness of the female immune system may be a factor in female predominance of chronic bronchitis.”
In addition to this higher risk of developing the disease, women are now more likely to die of it because of a range of factors. “There is a bias against not diagnosing women with COPD who have COPD,” Hatipoglu says. “Although they start complaining early of symptoms, diagnosis is delayed,” and in some cases it may be misdiagnosed as asthma. Delaying effective treatment can hasten the progression of the disease, leading to death earlier. He says women also tend to have more exacerbations of the disease as well, and among the 8 percent or so of COPD patients who never smoked, “women are the majority.”
Although there are some differences between how men and women experience COPD, Hatipoglu says this has not led to any difference in how the disease is treated in men versus women. “We treat COPD in men and women the same despite these gender specific differences. But again, this is an area of research, too. People are looking into whether men and women should be treated differently because of these differences, but so far it hasn’t panned out. We haven’t found any angles.”
[See: 16 Ways Your Body Adjusts to a New Climate.]
The bottom line for women who find themselves short of breath — particularly if you have a history of smoking — is to speak with your doctor as soon as possible. If you’re still smoking, quitting is the first order of business. If you’ve already quit, your doctor may be able to offer you treatments that can help alleviate some of your symptoms and improve your quality of life. Although COPD isn’t curable, it is a manageable disease, and you can still lead a relatively normal life, but only if you see treatment and follow your doctor’s advice.
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Are Women More Susceptible to COPD Than Men? originally appeared on usnews.com
